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Nir Hus MD, PhD, FACS
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Bile leaks after lapchole Nir Hus MD., PhD. http://www.nirhus.com
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laparoscopic cholecystectomy has become the gold standard . But its safety in acute cholecystitis is debatable. The traditional dictum to wait for 6 weeks before contemplating removal of the gall bladder still remains the safest option rather than removing the gall bladder on an emergency basis and heightening the chances of bile duuct injury leading to a surgical disaster.The presentation outlines the evaluation and management of bile duct injuries.
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QUIZ OSCE (1).pptx
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Comments: Excellent paper. It’s obvious that you put quite a bit of work into this. Unfortunately, your paper needs adequate citations in the body of the text to meet our standards on plagiarism. You need to cite each textbook from your bibliography whenever you quote or use some information from the textbook or other resource. For example, writing (Jones 285) after the quote or information used means that you got it from the book whose author was Jones and the info came from page 285. Laparoscopic cholecystectomy is a procedure in which laparoscopic techniques remove the gallbladder. It is the standard of care for symptomatic gallbladder disease, of which most are performed for symptomatic cholelithiasis. Other indications include acute cholecystitis, biliary dyskinesia, and gallstone pancreatitis. Describe the reasons a patient might have the selected surgical procedure The typical reason a cholecystectomy is a treatment of choice is inflammatory changes of gallbladder or blockage of bile flow by gallstones. Symptomatic cholelithiasis is the most common reason where gallstones in the gallbladder are blocking the bile flow and cause inflammation. The patient usually complains of episodic epigastric pain and right upper quadrant pain that radiates to the right shoulder. This pain is found to occur several hours after heavy meals and the patient experiences nausea, vomiting, bloating, fever, and right upper quadrant tenderness. Another condition is acute cholecystitis, where inflammation and symptoms are more prominent. The patient may have a fever, constant pain, positive Murphy's sign, or leukocytosis. Acute cholecystitis may be caused by calculous biliary tract disease with confirmed gallstones in the abdominal US. Acute acalculous cholecystitis usually occurs in critically ill patients, those with prolonged total parenteral nutrition, and some immunosuppressed patients. Patients with episodes of right upper quadrant pain (which are ‘classic' for biliary pain without evidence of cholelithiasis of US or ERCP) may also be referred for laparoscopic cholecystectomy. Gallstone pancreatitis (when small stones pass through the cystic duct) confirmed by cholangiography is another indication for laparoscopic cholecystectomy. Describe the reasons a patient might be disqualified for this surgery and the options for the patient if any A patient might be excluded for laparoscopic cholecystectomy due to acute general conditions that are a contraindication for any surgery such as an acute cardiac failure, uncontrolled hypertension, acute renal failure, pneumonia, etc. The condition should be treated by a primary care provider or specialist and the patient should be stable prior surgery. Additional contraindications may include the inability to tolerate general anesthesia, significant portal hypertension, uncorrectable coagulopathy, and multiple prior operations. List the diagnostic tests and lab work that an attending surgeon might order and desc.
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
drandy1
Comments: Excellent paper. It’s obvious that you put quite a bit of work into this. Unfortunately, your paper needs adequate citations in the body of the text to meet our standards on plagiarism. You need to cite each textbook from your bibliography whenever you quote or use some information from the textbook or other resource. For example, writing (Jones 285) after the quote or information used means that you got it from the book whose author was Jones and the info came from page 285. Laparoscopic cholecystectomy is a procedure in which laparoscopic techniques remove the gallbladder. It is the standard of care for symptomatic gallbladder disease, of which most are performed for symptomatic cholelithiasis. Other indications include acute cholecystitis, biliary dyskinesia, and gallstone pancreatitis. Describe the reasons a patient might have the selected surgical procedure The typical reason a cholecystectomy is a treatment of choice is inflammatory changes of gallbladder or blockage of bile flow by gallstones. Symptomatic cholelithiasis is the most common reason where gallstones in the gallbladder are blocking the bile flow and cause inflammation. The patient usually complains of episodic epigastric pain and right upper quadrant pain that radiates to the right shoulder. This pain is found to occur several hours after heavy meals and the patient experiences nausea, vomiting, bloating, fever, and right upper quadrant tenderness. Another condition is acute cholecystitis, where inflammation and symptoms are more prominent. The patient may have a fever, constant pain, positive Murphy's sign, or leukocytosis. Acute cholecystitis may be caused by calculous biliary tract disease with confirmed gallstones in the abdominal US. Acute acalculous cholecystitis usually occurs in critically ill patients, those with prolonged total parenteral nutrition, and some immunosuppressed patients. Patients with episodes of right upper quadrant pain (which are ‘classic' for biliary pain without evidence of cholelithiasis of US or ERCP) may also be referred for laparoscopic cholecystectomy. Gallstone pancreatitis (when small stones pass through the cystic duct) confirmed by cholangiography is another indication for laparoscopic cholecystectomy. Describe the reasons a patient might be disqualified for this surgery and the options for the patient if any A patient might be excluded for laparoscopic cholecystectomy due to acute general conditions that are a contraindication for any surgery such as an acute cardiac failure, uncontrolled hypertension, acute renal failure, pneumonia, etc. The condition should be treated by a primary care provider or specialist and the patient should be stable prior surgery. Additional contraindications may include the inability to tolerate general anesthesia, significant portal hypertension, uncorrectable coagulopathy, and multiple prior operations. List the diagnostic tests and lab work that an attending surgeon might order and desc.
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
cargillfilberto
Drs. Kylee Brooks and Parker Hambright are Emergency Medicine Residents and Drs. Alexis Holland and William Lorenz are Surgery Residents at Carolinas Medical Center in Charlotte, NC. They are interested in medical education. With the guidance of Drs. Kyle Cunningham, Brent Matthews, and Michael Gibbs, they aim to help augment our understanding of emergent abdominal imaging. Follow along with the EMGuideWire.com team as they post these monthly educational, self-guided radiology slides. This month’s cases include: - Pyogenic Liver Abscess - Bladder Rupture - Sigmoid Volvulus
Drs. Brooks, Hambright, Holland, and Lorenz’s CMC Abdominal Imaging Mastery P...
Drs. Brooks, Hambright, Holland, and Lorenz’s CMC Abdominal Imaging Mastery P...
Sean M. Fox
Gallbladder perforation requiring an emergent treatment is usually a complication of cholecystitis [1]. Acute cholecystitis develops in up to 2% of patients affected by asymptomatic cholelithiasis. Gallbladder perforation occurs in 2 to 11% of acute cholecystitis cases. Due to the high mortality that can be caused by a delay in the correct diagnosis and following adequate surgical treatment, gallbladder perforation represents a special diagnostic and surgical challenge [2]. https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000505.php For more Open access journals in Crimson Publishers Please click on: https://crimsonpublishers.com/ For more articles in Open access journal of Innovation in Surgical Medicine Open Access Journal Please click on: https://crimsonpublishers.com/smoaj/index.php
Spontaneous Gall Bladder Perforation: A rare clinical entity, a diagnostic an...
Spontaneous Gall Bladder Perforation: A rare clinical entity, a diagnostic an...
Crimsonpublisherssmoaj
Sub phrenic collections are a common sequel to hepatobiliary surgery. Prompt diagnosis and treatment are necessary to reduce the morbidity and mortality to a bare minimum. Contrast enhanced CT (CECT) scan is the best imaging modality to identify the location and approximate size of the collection. Laparoscopic drainage is the best option for treating sub phrenic abscesses. A case of a sub phrenic abscess drained laparoscopically is presented to highlight the efficacy of this approach.
Laparoscopic drainage of subphrenic abscess
Laparoscopic drainage of subphrenic abscess
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The lecture has been given on May 26th, 2011 by Dr. Salah Mohammad Fatih.
Radiology 5th year, 5th lecture (Dr. Salah Mohammad Fatih)
Radiology 5th year, 5th lecture (Dr. Salah Mohammad Fatih)
College of Medicine, Sulaymaniyah
Bladder rupture is a very morbid injury following blunt or penetrating lower abdominal trauma. Prompt diagnosis is crucial to initiate optimal treatment. Intraperitoneal bladder rupture is associated with haematuria and biochemical features of renal failure. Cystogram is diagnostic. Immediate open surgical repair is the main stay of treatment. A case of intraperitoneal rupture diagnosed preoperatively by the presence of haematuria and pseudorenal failure is presented to highlight the association of posttraumatic haematuria and pseudorenal failure in such injuries.
Posttraumatic hematuria with pseudorenal failure: A Diagnostic lead for Intra...
Posttraumatic hematuria with pseudorenal failure: A Diagnostic lead for Intra...
KETAN VAGHOLKAR
Cholecystectomy is one of the commonest hepatobiliary procedures performed in general surgical practice. Both laparoscopic as well as open cholecystectomies have their place in modern-day surgical practice. Post cholecystectomy syndrome is a known entity affecting approximately 20% of patients who have undergone cholecystectomy. Post cholecystectomy pancreatitis is an uncommon and rare complication. A case of acute early post cholecystectomy pancreatitis is presented to create an awareness of this rare but misleading and morbid complication.
Post cholecystectomy pancreatitis: a misleading entity
Post cholecystectomy pancreatitis: a misleading entity
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ijmas CASE REPORT
Ijmas 200
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QUIZ OSCE (1).pptx
QUIZ OSCE (1).pptx
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
Comments Excellent paper. It’s obvious that you put quite a bit of .docx
Drs. Brooks, Hambright, Holland, and Lorenz’s CMC Abdominal Imaging Mastery P...
Drs. Brooks, Hambright, Holland, and Lorenz’s CMC Abdominal Imaging Mastery P...
Spontaneous Gall Bladder Perforation: A rare clinical entity, a diagnostic an...
Spontaneous Gall Bladder Perforation: A rare clinical entity, a diagnostic an...
Laparoscopic drainage of subphrenic abscess
Laparoscopic drainage of subphrenic abscess
Radiology 5th year, 5th lecture (Dr. Salah Mohammad Fatih)
Radiology 5th year, 5th lecture (Dr. Salah Mohammad Fatih)
Posttraumatic hematuria with pseudorenal failure: A Diagnostic lead for Intra...
Posttraumatic hematuria with pseudorenal failure: A Diagnostic lead for Intra...
Post cholecystectomy pancreatitis: a misleading entity
Post cholecystectomy pancreatitis: a misleading entity
Ijmas 200
Ijmas 200
Acute pancreatitis case discussion
Acute pancreatitis case discussion
Abdominal trauma, an outlined management
Abdominal trauma, an outlined management
Plus de Nir Hus MD, PhD, FACS
Review some recent (2009) topics used in the absite and general surgical board exams, http://www.nirhus.com
Topics absite
Topics absite
Nir Hus MD, PhD, FACS
GI review - Stomach http://www.nirhus.com
GI review - Stomach
GI review - Stomach
Nir Hus MD, PhD, FACS
GI review - Small bowel http://www.nirhus.com
GI review - Small bowel
GI review - Small bowel
Nir Hus MD, PhD, FACS
GI review - Liver and billiard http://www.nirhus.com
GI review - Liver and billiary
GI review - Liver and billiary
Nir Hus MD, PhD, FACS
GI review - Exocrine pancreas http://www.nirhus.com
GI review - Exocrine pancreas
GI review - Exocrine pancreas
Nir Hus MD, PhD, FACS
GI review - Esophagus http://www.nirhus.com
GI review - Esophagus
GI review - Esophagus
Nir Hus MD, PhD, FACS
GI review - Colon & anorectic http://www.nirhus.com
GI review - Colon & anorectum
GI review - Colon & anorectum
Nir Hus MD, PhD, FACS
Part 1 of 3, review on esophagus lecture, http://www.nirhus.com
Esophagus review 1 Nir Hus MD., PhD.
Esophagus review 1 Nir Hus MD., PhD.
Nir Hus MD, PhD, FACS
Bullet points on topics used in the Absite, General surgery Board exams,, http://www.nirhus.com
Absite and Surgical Boards - Bullet points
Absite and Surgical Boards - Bullet points
Nir Hus MD, PhD, FACS
Questions and Topics used in the surgical board exams. The absite exam and the general surgical board exams, Nir Hus MD., PhD. http://www.nirhus.com
Absite Review Questions and Topics, Nir Hus MD., PhD.
Absite Review Questions and Topics, Nir Hus MD., PhD.
Nir Hus MD, PhD, FACS
Absite killer 2004
Absite killer 2004
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 53 54 iv
Nir Hus Q 53 54 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 42 43 iv
Nir Hus Q 42 43 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 31 32 iv
Nir Hus Q 31 32 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 27 28 iv
Nir Hus Q 27 28 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 25 26 iv
Nir Hus Q 25 26 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 18 21 iv
Nir Hus Q 18 21 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 15 17 iv
Nir Hus Q 15 17 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 9 11 iv
Nir Hus Q 9 11 iv
Nir Hus MD, PhD, FACS
Slides with topics that are covered and were tested in the recent Absite exams. Nir Hus MD., PhD. http://www.nirhus.com
Nir Hus Q 4 6 iv
Nir Hus Q 4 6 iv
Nir Hus MD, PhD, FACS
Plus de Nir Hus MD, PhD, FACS
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Topics absite
Topics absite
GI review - Stomach
GI review - Stomach
GI review - Small bowel
GI review - Small bowel
GI review - Liver and billiary
GI review - Liver and billiary
GI review - Exocrine pancreas
GI review - Exocrine pancreas
GI review - Esophagus
GI review - Esophagus
GI review - Colon & anorectum
GI review - Colon & anorectum
Esophagus review 1 Nir Hus MD., PhD.
Esophagus review 1 Nir Hus MD., PhD.
Absite and Surgical Boards - Bullet points
Absite and Surgical Boards - Bullet points
Absite Review Questions and Topics, Nir Hus MD., PhD.
Absite Review Questions and Topics, Nir Hus MD., PhD.
Absite killer 2004
Absite killer 2004
Nir Hus Q 53 54 iv
Nir Hus Q 53 54 iv
Nir Hus Q 42 43 iv
Nir Hus Q 42 43 iv
Nir Hus Q 31 32 iv
Nir Hus Q 31 32 iv
Nir Hus Q 27 28 iv
Nir Hus Q 27 28 iv
Nir Hus Q 25 26 iv
Nir Hus Q 25 26 iv
Nir Hus Q 18 21 iv
Nir Hus Q 18 21 iv
Nir Hus Q 15 17 iv
Nir Hus Q 15 17 iv
Nir Hus Q 9 11 iv
Nir Hus Q 9 11 iv
Nir Hus Q 4 6 iv
Nir Hus Q 4 6 iv
Dernier
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Bile leaks after lapchole Nir Hus MD., PhD.
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Intraoperative cholangiogram
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CT SCAN
6 days post op
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Follow up CT
Scan
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Bile Leaks After
Laparoscopic Cholecystectomy
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The End
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